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Crocus Homecare
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Inspection carried out on 3 August 2016

During a routine inspection

The inspection took place on the 3 August 2016. The provider was given 48 hours’ notice of the inspection, as this was a small service where people were often out during the day and we needed to make sure that the registered manager would be available to meet us. The service was last inspected in July 2014.

Crocus Homecare is a small community based service registered to provide care and support to people in their own homes. It currently provides care for seven people in their own homes in the Derbyshire Dales.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service were safe in the care of staff from Crocus Homecare. Staff received training and support and told us they were confident to report any concerns they may have, if they felt a person was at risk of harm or abuse. Staff were recruited safely and all pre-employment safety checks were completed before they started working for Crocus Home Care.

Staff received relevant training that prepared them to offer personalised care to people, based on individual need. Staff were supervised and supported by the management team who had the qualifications and experience to manage the service and the staff. People were asked for consent before care was offered and staff understood the principles of the Mental Capacity Act 2005.

People were supported to maintain their health. Food and hydration was monitored where required and people were supported to access community health and social care services.

Staff developed positive caring relationships with people, based on mutual respect and equality. They were compassionate and enjoyed caring for people and improving their quality of life. Families were confident in leaving their loved ones in the care of Crocus Homecare and had nothing but praise for the carers and the management team; who they said, really understood their relative’s individual needs and preferences.

People were involved in planning all aspects of their care. Their views and preferences were actively sought and respected by the staff team, whose hours were arranged to provide consistent care for people. Families told us they appreciated the consistency of carers and felt their loved ones were more comfortable when they had the same people visiting them. They also said this enabled their relatives to be cared for with dignity and their privacy was respected.

People received personalised care from staff who understood their individual needs and interests. Families told us the service was quick to respond to changing needs and the registered manager was approachable and took time to understand people’s requirements, before agreeing a care plan with them. People met the staff who would be caring for them, before care began; when all needs were discussed and everyone got to know each other. Families were reassured by the positive caring relationships the staff had with their loved ones and explained how this had a positive impact on the wellbeing of the whole family, who also felt cared for, in the process.

The service routinely sought and responded to feedback and used it to improve the care experience for people and families. The staff were flexible and adapted to changing needs, they told us that people were at the heart of what they do.

The registered manager led and managed the staff team effectively and was committed to providing good quality care, that enabled people to remain in their own homes, for as long as possible. There was a positive and inclusive culture in the service, where people and staff felt valued.

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During a routine inspection

This is a summary of what we found -

Is the service safe?

People told us that they felt safe. Safeguarding procedures are robust and staff understood how to safeguard the people they supported.

The provider had policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards, although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit it. This meant that people would be safeguarded as required.

The staff had received training on infection control and told us the measures they had taken when supporting people at home in order to prevent any risks of infection.

Is the service effective?

People told us that they were happy with the care that had been delivered to them. One person told us, “The staff are absolutely wonderful. They came late at night and stayed with me until morning. They made sure that I had been well looked after”.

The services worked well with other agencies and services to make sure people received care in a coherent way.

One relative told us, “The staff are very reliable and trustworthy.”

People’s health and care needs were assessed with them, and they were involved in writing their care plans. People told us their support needs had been reviewed on a regular basis to meet any changing needs.

Is the service caring?

We spoke with people being supported by the service and their relatives. We asked them for their opinions about the staff that supported them. One person told us, “I am absolutely delighted with the service. All the carers are excellent.” Another told us, “The staff are always so punctual and their attitude is very pleasant.” When speaking with staff it was clear that they genuinely cared for the people they supported.

Relatives we spoke told us they were very satisfied with the support and care provided.

Is the service responsive?

They all told us they could raise any concerns and they would be dealt with. They told us that the service had been very flexible and that their needs had been met. People’s likes and dislikes had been detailed and care and support had been provided in accordance with people’s wishes.

People were treated with respect and dignity by the staff. We saw that people were given choice in their care and all the relatives we spoke to told us they were kept informed.

One person told us, “The service is very flexible. I needed support during the night and they were able to help”.

Is the service well-led?

People were involved in satisfaction surveys and regular audits of their views. Relatives also completed a satisfaction survey.

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During a routine inspection

People we spoke with were happy with the support they received from Crocus Homecare. One person told us, "I am extremely happy. The staff are professional and well trained. Excellent in every way."

We found that effective systems were in place for assessing and monitoring the quality of care delivered. People receiving support told us they had not needed to complain but were confident if they had concerns, they would be responded to.

We saw that a detailed assessment was made of people’s needs on referral to the service. The assessments included information about all important areas of the person's care needs and preferences.

We saw that information about people's health needs and any risks that could affect them were recorded. This included guidance for staff to ensure they were aware of any specific health conditions or disabilities including signs of deterioration in and what to do in case of an emergency occurring. This meant that people received consistent, safe and appropriate care that met their needs and ensured their welfare.

We found that recruitment procedures were robust and ensured suitable staff were employed to deliver people's care. We spoke with staff who received appropriate training and support from the provider. They were also aware of how to safeguard people who were vulnerable to abuse.

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During a routine inspection

People we spoke with were happy with the care they received from Crocus Homecare. One person told us, " The staff are all very well trained and professional." They also told us, "I trust them completely. The care is superb."

We found that people's needs were assessed thoroughly and that care was well planned and individualised. We also saw that medication was well managed and that people had detailed plans about how they were helped with this.

People's consent was obtained for their care and if they were unable to consent, for example due to dementia, the provider had appropriate systems in place in line with legal requirements.

We saw that staff received appropriate training and were regularly supervised and supported by the manager.

Crocus Homecare had an effective system in place to deal with any complaints or concerns.

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During a routine inspection

People we spoke with told us” the agency is excellent, wonderful, and first rate.” “There is nothing they could do better. They help me maintain my independence and without them I would not be able to get out.”

We were told “they keep good contact with people and the staff are lovely and sincere.”

Inspection ratings

We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels:

Outstanding – the service is performing exceptionally well.

Good – the service is performing well and meeting our expectations.

Requires improvement – the service isn't performing as well as it should and we have told the service how it must improve.

Inadequate – the service is performing badly and we've taken enforcement action against the provider of the service.

No rating/under appeal/rating suspended – there are some services which we can’t rate, while some might be under appeal from the provider. Suspended ratings are being reviewed by us and will be published soon.

Ticks and crosses

We don't rate every type of service. For services we haven't rated we use ticks and crosses to show whether we've asked them to take further action or taken enforcement action against them.

There's no need for the service to take further action. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service.

The service must make improvements.

At least one standard in this area was not being met when we inspected the service and we have taken enforcement action.